MEMORIAL MEDICAL CENTER (SIU) (NPI# 1548540982) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548540982 |
| Entity Type | Organization |
| Organization Name | MEMORIAL MEDICAL CENTER (SIU) |
| Practice Address |
701 N 1st St Springfield IL 62702-3757 |
| Mailing Address |
701 N 1st St. Springfield IL 62794-9636 |
| Practice Telephone | 2175454735 |
| Enumeration Date | 2011-08-17 |
| Last Update Date | 2011-08-17 |
| Authorized Official Name | DR. TESFAYE TELILA (RESIDENT.) |
| Authorized Official Telephone | 2175450182 |
| Authorized Official Credential | M.D |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 273R00000X | Psychiatric Unit | ========= | IL | Hospital Units |
| Street Address |
701 N 1ST ST |
| City | SPRINGFIELD |
| State | IL |
| Zip Code | 62702-3757 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982607123 | Memorial Home Services | Home Health | 701 N 1st St, Springfield, IL 62781-4952 | 2005-05-23 |
| 1316552524 | Mary Ann Seagle | Nurse Practitioner | 701 N 1st St, Springfield, IL 62781-0001 | 2020-09-14 |
| 1497372361 | Amir Mcphearson | Internal Medicine | 701 N 1st St, Springfield, IL 62702-3757 | 2020-06-26 |
| 1508482597 | Kirsten Kay Carew | Internal Medicine | 701 N 1st St, Springfield, IL 62702-3757 | 2020-06-25 |
| 1699391482 | Aruya Davis | Registered Nurse | 701 N 1st St, Springfield, IL 62781-0001 | 2020-06-17 |
| 1497370852 | Alyssa Rose Jimerson | Nurse Anesthetist, Certified Registered | 701 N 1st St, Springfield, IL 62781-0001 | 2020-06-11 |
| 1649895038 | Elisha Boyd | Nurse Practitioner | 701 N 1st St, Springfield, IL 62702-3757 | 2020-06-10 |
| 1275158990 | Ashley L Mcgrath | Nurse Anesthetist, Certified Registered | 701 N 1st St, Springfield, IL 62781-0001 | 2020-06-09 |
| 1205451812 | Christopher Evan Bejcek | Orthopaedic Surgery | 701 N 1st St, Springfield, IL 62702-3757 | 2020-06-09 |
| 1912521790 | Neil Carter Parker | Internal Medicine | 701 N 1st St, Springfield, IL 62702-3757 | 2020-06-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457866519 | Mohammad Jamal Uddin Ansari | Internal Medicine | 751 N Rutledge St Ste 400, Springfield, IL 62702 | 2017-12-11 |
| 1588105811 | Mickey Graphia | Surgery | 701 N 1st St # D346, Springfield, IL 62702 | 2017-03-20 |
| 1376908913 | Abdul Hannan | Internal Medicine | 315 W Carpenter St # B, Springfield, IL 62702 | 2015-12-28 |
| 1871986414 | Rachel Hoselton | Nurse Practitioner | 400 N 9th St Fl 4, Springfield, IL 62702 | 2015-03-06 |
| 1548697774 | Alyssa Wilson | Behavioral Analyst | 232 Bruns Lane, One Sparcenter Plaza, Springfield, IL 62702 | 2013-10-02 |
| 1174965446 | Amy Wilson | Speech-Language Pathologist | 2120 West Washington Street, Springfield, IL 62702 | 2013-07-26 |
| 1275898116 | Pele Boutrous Dina | Pediatrics | 415 N 9th St # 4w16, Springfield, IL 62702 | 2012-07-06 |
| 1427327733 | Brook D Croke | Genetic Counselor, MS | 400 N. 9th Street, 3rd Floor Clinic B, Springfield, IL 62702 | 2011-12-16 |
| 1629352604 | Renae M Sanchez | Pharmacist | 3216 East Clearlake Ave, Springfield, IL 62702 | 2011-10-07 |
| 1982915302 | William Leland Zelkovich | Radiology | 701 N 1st, Springfield, IL 62702 | 2010-06-30 |
| Find all providers in zip 62702 | ||||
| Taxonomy Code | 273R00000X |
| Grouping | Hospital Units |
| Classification | Psychiatric Unit |
| In general, a distinct unit of a hospital that provides acute or long-term care to emotionally disturbed patients, including patients admitted for diagnosis and those admitted for treatment of psychiatric problems on the basis of physicians' orders and approved nursing care plans. Long-term care may include intensive supervision to the chronically mentally ill, mentally disordered or other mentally incompetent persons; (2) For Medicare, a distinct part of a general acute care hospital admitting only patients whose admission to the unit is required for active treatment, whose treatment is of an intensity that can be provided only in an inpatient hospital setting, and whose condition is described by a psychiatric principal diagnosis contained in the Third Edition of the American Psychiatric Association Diagnostic and Statistical Manual or in Chapter 5 (Mental Disorders) of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). The unit must furnish, through the use of qualified personnel, psychological services, social work services, psychiatric nursing, occupational therapy, and recreational therapy. The unit must maintain medical records that permit determination of the degree and intensity of treatment provided to individuals who are furnished services in the unit; the unit must meet special staff requirements in that the unit must have adequate numbers of qualified professional and supportive staff to evaluate inpatients, formulate written, individualized, comprehensive treatment plans, provide active treatment measures and engage in discharge planning. |
| Notes: Source: (1) AHA Annual Survey p. A10 1996 AHA Guide; (2) Code of Federal Regulations #42, Section 412.27. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083110407 | A Mcfarland Mental Health Center - Lincoln North | Psychiatric Unit | 901 E Southwind Rd, Springfield, IL 62703-5125 | 2018-04-04 |
| 1861613630 | Dhs-mcfarland Mhc-kennedy Hall | Psychiatric Unit | 901 Southwind Dr, Springfield, IL 62703-5125 | 2007-05-01 |
| 1841417318 | Dhs-a. Mcfarland Mhc-stevenson Hall | Psychiatric Unit | 901 Southwind Dr, Springfield, IL 62703-5125 | 2007-04-19 |
| 1033249982 | Idhs-mcfarland Mhc-douglas Hall | Psychiatric Unit | 901 Southwind Dr, Springfield, IL 62703-5125 | 2007-03-07 |
| 1508996257 | Idhs-mcfarland Mhc-monroe Hall | Psychiatric Unit | 901 Southwind Dr, Springfield, IL 62703-5125 | 2007-03-06 |
| 1144350802 | Idhs-mcfarland Mhc-jefferson Hall | Psychiatric Unit | 901 Southwind Dr, Springfield, IL 62703-5125 | 2007-03-06 |
| 1528198280 | Idhs-mcfarland Mhc-lincoln Hall | Psychiatric Unit | 901 Southwind Dr, Springfield, IL 62703-5125 | 2007-03-06 |
| 1982730255 | Idhs-mcfarland Mhc- Stevenson Hall | Psychiatric Unit | 901 Southwind Dr, Springfield, IL 62703-5125 | 2007-02-23 |
| 1962537308 | Idhs-mcfarland-kennedy Hall | Psychiatric Unit | 901 Southwind Dr, Springfield, IL 62703-5125 | 2007-02-23 |
| 1982744983 | Sgoh Acquisition Inc | Psychiatric Unit | 2828 N National Ave, Springfield, MO 65803-4306 | 2007-02-07 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 62702 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.